Abstract
PurposeMultifocal intraocular lenses (MIOLs) are often discouraged in patients with or at risk of retinal disorders (including diabetic retinopathy, age-related macular degeneration, and epiretinal membranes), as MIOLs are believed to reduce contrast sensitivity (CS). Concerns with MIOLs have also been raised in individuals with visual field defects, fixation instability or eccentric preferred retinal locations. The aim of this study is to review the influence of MIOL on quality of vision in patients with retinal diseases.MethodsWe reviewed the PubMed and Web of Science databases to identify relevant studies using the following keywords: multifocal intraocular lens, cataract surgery, cataract extraction, lens exchange, diabetic retinopathy, age-related macular degeneration, and contrast sensitivity.ResultsStudies evaluating CS in MIOLs present conflicting results: MIOLs either did not influence CS or resulted in worse performance under low-illuminance conditions and higher spatial frequencies when compared to monofocal IOLs. Nevertheless, MIOLs preserved CS levels within the age-matched normal range. Two studies reported that patients with concurrent retinal diseases receiving a MIOL, both unilaterally and bilaterally, reported a significant improvement in visual-related outcomes. Individuals with a monofocal IOL in one eye and a MIOL in the fellow eye reported greater subjective satisfaction with the MIOL.ConclusionWe were unable to find evidence suggesting that patients with retinal diseases should be advised against MIOLs. Nevertheless, more research is needed to address the aforementioned concerns and to optimize the use of MIOLs in eyes with retinal disease.
Highlights
Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Helsinki, Helsinki, Finland 5 Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, FinlandAdvances in cataract surgery and refractive lens exchange have enabled these techniques to be used to achieve precise and desired refractive outcomes[1]
The aim of this study is to review the influence of Multifocal intraocular lenses (MIOLs) on quality of vision in patients with retinal diseases
In 1978, Arden and Jacobson claimed that contrast sensitivity is independent of age, and since several studies have sought an association between contrast sensitivity and age [4]
Summary
Advances in cataract surgery and refractive lens exchange have enabled these techniques to be used to achieve precise and desired refractive outcomes[1]. This has raised patients’ expectations of excellent uncorrected distance visual acuity[2]. With monofocal intraocular lenses (IOLs), the desire for freedom from spectacles cannot be completely met. Multifocal intraocular lenses (MIOLs) are used more commonly and to a considerable extent for refractive purposes in non-cataractous eyes [3]. It is believed that as MIOLs decrease contrast sensitivity, so they are advised against in patients with retinal disorders
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